Ethan J. Raker (
Mariana C. Arcaya is an associate professor of urban planning at the Massachusetts Institute of Technology, in Cambridge, Massachusetts.
Health Aff (Millwood). 2020 Dec;39(12):2128-2135. doi: 10.1377/hlthaff.2020.01161.
Climate change exacerbates the severity of natural disasters, which disproportionately affect vulnerable populations. Mitigating disasters' health consequences is critical to promoting health equity, but few studies have isolated the short- and long-term effects of disasters on vulnerable groups. We filled this gap by conducting a fifteen-year (2003-2018) prospective study of low-income, predominantly Black parents who experienced Hurricane Katrina: the Resilience in Survivors of Katrina (RISK) Project. Here we describe this project and synthesize lessons from work that has resulted from it. Our findings can guide policy makers, service providers, and health officials in disaster planning and response. We synthesize them into an organizational schema of five priorities: Primary efforts should be aimed at preventing exposure to trauma through investments in climate resilience and by eliminating impediments to evacuation, health care policies should promote uninterrupted and expanded access to care, social services should integrate and strive to reduce the administrative burden on survivors, programs should aid survivors in forging or strengthening connections to their communities, and policy makers should fund targeted long-term services for highly affected survivors.
气候变化加剧了自然灾害的严重程度,这些灾害对弱势群体造成了不成比例的影响。减轻灾害对健康的影响对于促进健康公平至关重要,但很少有研究能够孤立地研究灾害对弱势群体的短期和长期影响。我们通过对经历过卡特里娜飓风的低收入、以黑人为主要人口的父母进行了为期十五年(2003-2018 年)的前瞻性研究,填补了这一空白:卡特里娜飓风幸存者韧性研究(Resilience in Survivors of Katrina,RISK)项目。在这里,我们描述了这个项目,并综合了从中得出的经验教训。我们的发现可以为政策制定者、服务提供者和卫生官员在灾难规划和应对方面提供指导。我们将这些发现综合成一个五个优先事项的组织架构:首要任务应该是通过投资于气候适应能力和消除撤离障碍来防止接触创伤,医疗保健政策应促进不间断和扩大获得护理的机会,社会服务应整合并努力减少幸存者的行政负担,项目应帮助幸存者建立或加强与社区的联系,政策制定者应资助为受影响严重的幸存者提供有针对性的长期服务。